A retrospective review of cancers of the lip, oral cavity and pharynx (1CD-0-Classification 140-149) was undertaken for the period 1979 to 1988 in Kuwait. Although considered a rare disease, cancer of the head and neck is considered a major public health problem for certain developing countries. Previous studies have shown that head and neck cancers are among the leading cancer sites in Kuwait. The proportion of Lip, Oral + Pharyngeal cancers in the USA has remained at some 3% of all cancers during the latter part of the twentieth century. The proportion reported in Kuwait - 7.4% is 1.5 times the USA rate, but far below the 40-50% rates in some Asian countries. In the USA, 50% of L, O + P cancers are diagnosed before age 40, while in Kuwait 23.5% occur before age 40. The crude death rate in Kuwait at 1.07/100,000/year is well below the USA rate of 3.26/100,000/year. The non-Kuwaiti male/female ratio (1983-1987) is similar to the USA (1975-1980) ratio, at 2:1. The Kuwaiti male/female ratio is about 1,1:1 (1983-1987) with a narrowing of this ratio over the last 20 years. When compared by site, the findings are quite dissimilar to the USA with the nasopharynx and salivary glands as the primary sites of cancer in Kuwait. The nasopharynx has been reported as the leading site cause of L + O + P cancers in other Mediterranean and Arab countries. In the USA, the oral cavity (Tongue, Floor, Gingival) is the leading site. In Bombay, the tongue, mouth and hypopharynx are the leading sites. The age adjust nasopharyngeal cancers incidence rate for Kuwaiti males is 1.8 - 2.6 times greater than the rates in US, Birminghan, N.Y. State or Bombay; for non-Kuwaiti males, 2.3-3.2 times greater; for Kuwait females, 2.7 - 8 times greater; for non-Kuwaiti females, 4-12 times greater. The non-Kuwaiti male rate is 3.8 times greater than the Kuwaiti males; the non-Kuwait female is 0.5 times greater than the Kuwaiti female. For Salivary gland cancers, the non-Kuwait age adjusted rates are 1.4 - 7 times greater than in these other countries or in Kuwaiti male. While these head and neck cancers remain at 7.4% of all case as reported for the period, total cancer cases, all diagnoses, rose from 4,037 in 1974-1982 to 10,539 in 1979-1988. The average annual cases of L +P +O cancers increased from 40 per year (1974-1982) to 78.4 per year (1979-1988) a gross increase of 96%, and when adjusted for population changed, a 34.3% increase occurred. Possible etiological factors related to these cancers are reviewed.
Saudi Dental Journal 1994;6(SI)-Abstr.021:p23

The purpose of this investigation was to study some of the oral precancerous and cancerous cases treated at Riyadh Military Hospital. Medical records for 60 patients were analyzed in relation to age, sex, lesion description, clinical diagnosis, histological diagnosis, treatment and oral habits.

Results showed that the age range for treated cases was between 2 years and 88 years with a mean age of 53 years. The male female ratio was 1.7:1 The most commonly affected site was buccal mucosa (25%) followed by mandibular alveolar ridge (22%), tongue (18%), lips (7%) maxillary alveolar ridge (5%), palate (5%), floor of the mouth(3%), nasopharynx, gingivae and antrum (1.7% each): In 6 cases (10%) more than one site were involved. About 50% of patients were smokers. The most common form of provided treatment was surgery (82%) followed by radiotherapy (65%) and chemotherapy (3.8%).

Findings of this study will help in conjunction with similar studies at other medical institution in Riyadh to build up a data base information about oral cancerous and precancerous lesions among Saudis.
Saudi Dental Journal 1994;6(SI)-Abstr.022:p24

The explosion of scientific knowledge and technology which occurred within the past few decades has reached out to leave its impact on all branches of the healing disciplines including oral pathology particularly the study of tumors of the oral cavity. Until recent years, chondrosarcoma was indiscriminantly classed with osteosarcoma, but careful review of clinical data had indicated the need for their definite separation. The aim of this study was to evaluate the nature and frequency of chondrosarcoma and osteosarcoma of the mandible and identify the specific histological and clinical differentiation of these malignant neoplasms to avoid misinterpretation of symptoms of an inflammatory process. A group of 7 patients who developed chondrosarcoma (2 cases) and osteosarcoma (5 cases) of the mandible are presented. The most common presenting symptoms of the patients were swelling of the involved area, producing a facial deformity, and pain, followed by loose teeth, paresthesia, toothache and bleeding. The median age of the patients at the time of appearance of the first related sympts was about 27 years and there was a predilection for occurrence in males. Surprisingly, in all cases, there was no proceeding history of trauma or of Paget's disease.
Saudi Dental Journal 1994;6(SI)-Abstr.023:p25

Odontogenic infections, fortunately enough, are mostly well localized to the orofacial region. Severe infection has a more serious fate, since it can spread to areas distant from the site of origin where it may present a serious life threatening situation. This type of infection is always referred to as deep space infection. Ludwigs angina, orbital abscess leading to cavernous sinus thrombosis and infratemporal space infections are examples of these cases where odontogenic infection can be a potentially lethal condition.

Discussion of these conditions with clinical examples and treatment modalities implemented are to be presented.
Saudi Dental Journal 1994;6(SI)-Abstr.024:p26

A national study of the oral health care delivery system is being conducted in Saudi Arabia. The methodology was based on the International Collaborative Study of Oral Health Outcomes (ICS-II). A part of that study is to survey the dental practitioners for their knowledge, attitudes and practices. A 128-item questionnaire was administered to dentists practicing in multiple countrywide locations (10 regions) and the number of respondents totaled 481. Results show that 92% wear a new pair of gloves for each patient; 85.32% wear a face mask for all procedures; 50.84% use eyewear or glasses for all procedures; 100% use a sterile disposable needle for each patient; 27.1% sterilize with autoclave handpieces after each patient; 90.2% sterilize with autoclave hand instruments after each use; and 89.3% have increased the use of infection control procedures since they learned about AIDS. Approximately 26.3% disagree and 8.5% strongly disagree that they have adequate infection control training to treat AIDS patients. Over 37.3% strongly agree and 30.3% agree that they feel unsafe treating AIDS patients.

It is concluded that Saudi Arabia, a rapidly modernizing middle income nation, is making excellent progress in implementing barrier techniques in the dental delivery system. In view of the worldwide AIDS epidemic, it is vital that this progress continue and greater efforts be made in this area with more information provided to dentists about AIDS and infection control.

Keywords:     Infection control, questionnaire survey, Saudi Arabia, dentists
Saudi Dental Journal 1994;6(SI)-Abstr.025:p27